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AIDS RESEARCH AND HUMAŃ RETROV!RUSES VoHjme 32. Numser 8.2016 -© Mary Ann L^oert. Inc.

DOI: 10.108$‘a <12015.0366

Virological Response and Drug Resistance 1 and 2 Years Post-Partum in HIV-lnfected Women Initiated on Life-Long

Antiretroviral Therapy in Malawi

Sandro Mancinelli; Clementina Maria Galluzzof Mauro Andreotti³ Giuseppe Liotta.' Haswel Jere.³ Jean Baptiste Sagno.³ Roberta Amici."’ Maria Franca Pirillo.'' Paola Scarcella, Maria Cristina Marazzi?

Stefano Yella? Leonardo Palombi; and Marina Giuliano*

Abstract

The objective of this study was to determine the virological response and the possible emergence of drug resistance at 1 and 2 years postpartum in HlV-positive pregnant women enrolled under the Option B approach and meedng the criteria for treatment. ln the study. women with baseline CD4^r <350/mm³ received a combi nań on of stavudine. Iamivudine, and nevirapine during pregnancy (from week 25 of gestation) and continued it indefinitely after delivery. HIV-RNA was measured at 12 and 24 months postpartum. Drug resistance mutations were assessed in those with HIV RNA >50copies/ml. Baseline resistance mutations were assessed in the entire cohort. A total of 107 women were studied. At baseline. resistance mutations were seen in 6.6% of the women. At 12 months. 26.7% of the women had >50 copies/ml and among them 12.9% had viro!ogical faiiure (HTV-RNA >1.000 copies/ml). At 24 months, detectable H1V RNA was seen in 28.3% of the women and virological faiiure in 10.1% of the women. Resistance mutations (mainly non-nucleoside reverse transcriptase inhibitors mutations) were seen in 40% of the women with detectable H1Y-RNA. Baseline mutations did not correlate with viro!ogical faiiure or the emergence of resistance at later time points. Virological faiiure 2 years postpartum and emergence of resistance were rare in tlils cohort of HlY-infected women. These findings are reassuring in the light of the new strategies for tlie prevention of mother-to-child H1Y trans mi ssion. re-commending life-long antiretroviral tlterapy administration.